Social ecological strategies for promoting healthy lifestyles.

Abstract

OVERVIEW In this discussion of social ecological strategies for promoting healthy lifestyles as an element of social ecological perspectives on health promotion, it may be useful to start by differentiating my view of health promotion from another that is often expressed. That start seems necessary because of common tendency to use term health promotion to mean only changing peoples’ behavior to enhance health. A broader and more appropriate concept comes from Ottawa Charter definition of health promotion: the process of enabling people to increase control over, and to improve, their own health. ’’1 Such control may be exercised both individually and collectively, former for one’s own self and latter for community. The Ottawa definition focusses on maintaining and, insofar as possible, expanding people’s capacity to extend enjoyable life. That capacity constitutes health. It resides in several bodily and mental functions, for example, having immunity against diseasecausing microorganisms; having intact organ systems such as cardiopulmonary system and liver; and sustaining cognition. Therefore obtaining vaccinations, getting adequate exercise, avoiding excessive alcohol, and keeping mentally active are all aspects of health promotion. Other important features of health promotion, however, include items not related to individual behavior, such as fluoridating and otherwise maintaining healthful water supplies, minimizing rodent infestation, and curtailing air pollution. In recent years, however, way people behave (what many call lifestyle) has dominated consideration of health promotion. The popularity of this view has followed recognition that certain kinds of individual behavior, such as tobacco use and alcohol abuse, are profoundly associated with health, and subsequently with mortality and disabil